crossing96/oncoscreening huggingface dataset:
Efficacy Evaluation of Multi-Slice Spiral CT in Patients with Muscle-Invasive Bladder Cancer after Neoadjuvant Chemotherapy with Gemcitabine and Cisplatin.	OBJECTIVE: This study aims to evaluate the predictive utility of multi-slice spiral computed tomography (MSCT) in assessing the response to neoadjuvant chemotherapy (NAC) in patients with muscle-invasive bladder cancer (MIBC). METHODS: The clinical data of patients with MIBC who received treatment at our institution between January 2022 and January 2024 were retrospectively analysed. The patients were assigned to an observation group or a control group according to whether pathological downstaging was achieved following NAC with a gemcitabine and cisplatin regimen. A multivariate logistic regression analysis was conducted to develop a clinical prediction model, and a receiver operating characteristic (ROC) curve was generated to assess its diagnostic performance. For the evaluation of the model's stability, all patients were randomly assigned to either a training set or a validation set in a 7:3 ratio. RESULTS: A total of 86 patients were included in the study, among whom 46 achieved pathological downstaging with a downstaging rate of 53.49%. Multivariate logistic regression analysis identified blood flow (BF; odds ratio (OR), 95% confidence interval (CI): 0.63 (0.48-0.81)) and blood volume (BV; OR, 95% CI: 0.04 (0.00-0.46)) measured by MSCT as independent predictors of NAC efficacy (p < 0.05). In the training set, the area under the ROC curve (AUC) was 0.94 (95% CI: 0.89-0.99), with a specificity of 0.86 and a sensitivity of 0.87. In the validation set, the AUC was 0.98 (95% CI: 0.93-1.00), with a specificity of 0.84 and a sensitivity of 0.88. The Hosmer-Lemeshow goodness-of-fit test indicated good calibration, with p-values of 0.504 and 0.915 in the training and validation sets, respectively. The calibration curve demonstrated strong concordance with the ideal 45° reference line, indicating close alignment between predicted and observed probabilities. Decision curve analysis further confirmed the clinical utility of the nomogram, showing a favourable net benefit across a wide range of threshold probabilities. CONCLUSIONS: Pre-chemotherapy BF and BV parameters measured by MSCT were identified as significant predictors of NAC efficacy in patients with MIBC. The predictive model constructed using these parameters demonstrated strong performance in forecasting pathological downstaging following NAC.	bladder
Pan-Immune-Inflammation Value as a Predictor of Long-Term Outcomes in Patients with Urothelial Carcinoma of the Bladder: A Pilot Study.	BACKGROUND: Urothelial carcinoma of the bladder (UCB) demonstrates considerable heterogeneity, with markedly varying outcomes between non-muscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC). The pan-immune-inflammation value (PIV), derived from routine hematological parameters, has emerged as a novel biomarker reflecting systemic inflammation and immune dysregulation. This pilot, exploratory analysis evaluated the prognostic relevance of the PIV in UCB and contextualized PIV against other inflammation-based indices. METHODS: We retrospectively analyzed 119 patients with histologically confirmed UCB who were treated between 2019 and 2024. PIV was calculated as (neutrophils × platelets × monocytes) ÷ lymphocytes. Additional indices included the NLR, SII, SIRI, and PLR. Progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan-Meier analysis, and prognostic factors were assessed using Cox regression. RESULTS: Among 119 patients (median age, 72 years; 88% male), 68 were diagnosed with NMIBC and 51 with MIBC. Elevated PIV levels were significantly associated with NMIBC progression to MIBC (p = 0.028) and strongly correlated with NLR, SII, SIRI, and PLR. Patients with high PIV exhibited shorter OS (24 vs. 45 months) and PFS (20 vs. 35 months) than those with low patients (p < 0.001). Although the prognostic value was evident in the univariate analyses, PIV did not retain significance in multivariate models. CONCLUSION: Elevated PIV levels predict adverse survival outcomes and progression in UCB, underscoring its potential as a cost-effective and accessible biomarker for risk stratification. Prospective validation in larger cohorts is warranted to confirm its role in personalized patient management.	bladder
Lymphovascular Invasion is Predictive for Adjuvant Platinum Therapy Benefit in Urothelial Bladder Cancer.	INTRODUCTION: Perioperative platinum-based chemotherapy remains the standard systemic treatment for nonmetastatic muscle-invasive bladder cancer (MIBC). Adjuvant chemotherapy (AC) is recommended for patients with pT3/4 (stage IIIA) or lymph node-positive (LN+, stage IIIB) disease following radical cystectomy (RC). However, not all patients benefit equally, highlighting the need for predictive biomarkers. Lymphovascular invasion (LVI) is a known risk-factor in several cancers, including MIBC, but its predictive value for AC benefit remains unclear. Therefore, we aimed to assess whether LVI can predict response to platinum-based AC in MIBC. METHODS: We conducted a retrospective cohort study involving MIBC patients who underwent RC between 2005 and 2023 at two academic centers. Inclusion criteria were pT3/T4M0 or LN+ disease, with available LVI status and survival data. Patients were divided into a treatment (AC) and a control group (RC without AC). Overall survival (OS) was the primary endpoint; cancer-specific survival (CSS) was secondary. Statistical analysis was performed using Kaplan-Meier estimates, Cox proportional hazards models, and propensity score matching (PSM) to adjust for potential confounders. RESULTS: A total of 345 patients fulfilled the inclusion criteria of whom 92 (27%) received and 253 (73%) did not receive AC. LVI-positive patients demonstrated significantly improved OS and CSS when treated with AC (both P < .001), while no significant OS or CSS benefit was observed for AC-treated LVI-negative patients (P = .146 for OS, P = .975 for CSS). Results remained similar after PSM correction revealing survival benefit for AC treatment in LVI-positive but not in LVI-negative patients. CONCLUSIONS: This study demonstrates, for the first time, LVI status as a predictor of treatment benefit from platinum-based AC. Our results suggest that LVI status is an easily assessable biomarker to identify those patients who derive greater benefit from the treatment, while LVI-negative patients might be spared unnecessary chemotherapy and its associated toxicity.	bladder
Epidemiology, treatment patterns and effectiveness of adherence to Bacillus Calmette-Guérin therapy in intermediate and high-risk non-muscle-invasive bladder cancer patients: a retrospective cohort analysis using German health claims data.	PURPOSE: To assess the epidemiology, treatment patterns, and Bacillus Calmette-Guérin (BCG) instillations in Non-Muscle-Invasive Bladder Cancer (NMIBC) patients to evaluate guidelines compliance and effectiveness of adherence on real-world outcomes. METHODS: NMIBC patients with BCG-treatment were identified in a retrospective cohort study using German health claims data. The first BCG prescription was defined as index date. Crude and standardized annual incidence were calculated. Subsequent treatment regimens were described based on prescriptions to assess adherence. BCG-maintenance adherents were compared with non-adherents using a landmark time approach and Cox proportional hazard model. RESULTS: The annual standardized incidence per 100,000 for intermediate- and high-risk NMIBC patients ranged from 7.6 to 10.4 in males and 1.2 to 1.9 in females from 2017 to 2021. The main cohort consisted of 817 patients (mean age: 72.5; male: 78%). Most patients (98%) received transurethral resection of bladder tumor (TURBT) as initial treatment followed by BCG, with a median number of 13 BCG instillations per patient (IQR: 8-21). 28% continued BCG in the maintenance phase at 24 months post-induction and 62% received at least one Re-TURBT post-index. BCG maintenance-adherent patients showed lower risk compared with non-adherent patients: adjusted hazard ratio (aHR): 0.92 [0.73-1.18] for all-cause death; aHR: 0.49 [0.36-0.67] for advanced treatment; aHR: 0.65 [0.53-0.80] for disease progression. CONCLUSION: Real-world compliance with clinical guidelines may require improvement based on BCG maintenance duration and adherence to treatment schedules. The benefits of BCG adherence in improving oncology-relevant outcomes support guidelines recommendations for sufficient BCG maintenance.	bladder
Characterizing pelvic organ descent in women after radical cystectomy: an exploratory analysis.	PURPOSE: The effect of radical cystectomy (RC) on female pelvic floor support remains poorly understood; we aim to characterize the prevalence and severity of pelvic organ descent beyond the pubococcygeal line (PCL) in women who have undergone RC. METHODS: We retrospectively reviewed charts of women who underwent RC at our institution from 2017 to 2020. Using cross-sectional static imaging we measured pelvic organ position preoperatively, postoperatively, and throughout the surveillance period, as determined by intestinal position in relation to the PCL on sagittal images obtained in the supine position. Imaging review protocol was developed in collaboration with an expert genitourinary radiologist. We also recorded relevant covariates, including age, race/ethnicity, BMI, vaginal parity, pre-cystectomy prolapse, prior hysterectomy, constipation, and chronic cough. RESULTS: We identified 48 women with ≥ 1 preoperative and ≥ 1 postoperative scan who underwent RC at our institution out of a total of 80 female cystectomies in the study period. The majority underwent ileal conduit (83%) and non-organ sparing RC (81%). Median pelvic organ proximity to the PCL was significantly closer pre-operatively at 2 mm (IQR: -4, 6) below the PCL versus post-operatively at 14 mm (IQR: 9, 20) (p < 0.001). On scans with maximum organ descent, 96% of patients had increased organ descent from baseline. Median time to maximum descent was 9 months (IQR 3.8, 19.1). Patients undergoing continent diversions had greater post-operative descent than those with incontinent diversions. Vaginal deliveries were independently significantly associated with longer pelvic organ descent beyond the PCL (exp. β = 1.87 [95% CI: 1.21, 2.88; p = 0.009]). CONCLUSION: We describe the novel use of pre- and post-operative surveillance cross sectional imaging to characterize the natural history of post-RC pelvic floor descent. In our population, 96% of women demonstrate increased pelvic organ descent after RC on supine static imaging. Descent of pelvic floor support is an underappreciated consequence of RC.	bladder
Association Between Early on-Treatment Weight Loss With Enfortumab Vedotin Plus Pembrolizumab and Survival in Advanced Urothelial Carcinoma.	BACKGROUND: Combination therapy with enfortumab vedotin plus pembrolizumab (EV+P) is now the preferred first-line (1L) therapy for advanced urothelial carcinoma (aUC), but prognostic indicators for patients on 1L EV+P have not yet been described. PATIENTS AND METHODS: We conducted a retrospective cohort study of patients receiving 1L EV+P for aUC. We analyzed deidentified electronic health record data from the Flatiron Health database to identify adults with aUC who initiated EV+P between April 3, 2023 and December 31, 2024. Inclusion required absence of death, disease progression, or second line therapy start within 30 days of EV+P initiation, as well as documented weight measurements at the time of EV+P initiation (i.e., day 0) and day 28. We used Cox proportional hazards modeling with stabilized inverse probability treatment weighting (IPTW) to evaluate the association of early on-treatment weight loss with overall survival (OS), progression-free survival (PFS), and time to EV discontinuation. RESULTS: A total of 401 patients met study criteria. Of these, 78 patients (19.5%) experienced ≥ 5% weight loss by day 28 following EV+P initiation. Early on-treatment weight loss was associated with inferior OS (median 12.8 vs. 20.4 months; IPTW-adjusted HR [aHR] = 2.04 [1.41-2.95], P = 1.9 × 10(-4)), but not with PFS (aHR = 1.22 [0.89-1.65], P = .22) or time to EV discontinuation (aHR = 1.30 [0.96-1.77], P = .090). The association of early on-treatment weight loss with OS was conserved in subgroup analyses stratifying patients by baseline albumin or BMI. CONCLUSION: Early weight loss ≥5% occurred in one fifth of patients receiving 1L EV+P treatment and was associated with inferior overall survival.	bladder
Cu(2)(OH)PO(4)@PAA Nanoparticles for Highly Effective Combination of Chemodynamic, Photodynamic and Photothermal Therapies Against Bladder Cancer.	BACKGROUND: Due to the complex structure and variable microenvironment in the progression of bladder cancer, the efficacy of traditional treatment methods such as surgery and chemotherapy is limited. Tumor residual, recurrence and metastasis are still difficult to treat. The integration of diagnosis and treatment based on nanoparticles can offer the potential for precise tumor localization and real-time therapeutic monitoring. Photodynamic therapy (PDT), which generates reactive oxygen species (ROS) under laser irradiation, can be effectively combined with photothermal therapy (PTT) and chemodynamic therapy (CDT) to target non-muscle-invasive bladder tumors. In this study, Cu(2)(OH)PO(4)@PAA nanoparticles with photoacoustic (PA) imaging capabilities were utilized to explore their potential for precise intraoperative tumor identification and multimodal therapy. METHODS: The generation of ROS was detected to evaluate the potential of PDT and copper ion-induced CDT. Additionally, the PA imaging capability and biosafety of the nanoparticles were systematically evaluated. Finally, the anti-tumor efficacy of Cu(2)(OH)PO(4)@PAA-mediated CDT/PDT/PTT and the underlying mechanisms were assessed in vitro and in vivo. RESULTS: Cu(2)(OH)PO(4)@PAA could implement the CDT effect through a Cu(+)-induced Fenton-like reaction and substantial consumption of glutathione (GSH). Besides, Cu(2)(OH)PO(4)@PAA could execute NIR-I-triggered PDT by generating (1)O(2) and thermal images showed that Cu(2)(OH)PO(4)@PAA has the potential to perform PTT through light-heat energy conversion. Cu(2)(OH)PO(4)@PAA possessed dose-dependent PA signal transduction ability. Without laser exposure, Cu(2)(OH)PO(4)@PAA weakened cell viability, induced apoptosis, and suppressed epithelial-mesenchymal transition (EMT) by exhibiting the CDT effect alone. However, after the introduction of PDT and/or PTT, the above anti-tumor effects were significantly enhanced. CONCLUSION: This study systematically explores the combined anti-cancer mechanisms from the perspective of epithelial-mesenchymal transition, providing a theoretical and technical foundation for bladder cancer treatment.	bladder
Antiproliferative Effects of the Triterpene Ursolic Acid Natural Product in Bladder and Ovarian Tumor Cell Lines.	Bladder and ovarian cancers impose a significant burden on healthcare systems due to their high incidence, mortality rates, and the challenges associated with early diagnosis. Current chemotherapy regimens, which typically involve combinations of drugs, often cause severe side effects that negatively impact patient adherence and treatment efficacy. Recently, studies have explored the use of herbal medicines to mitigate the adverse effects of chemotherapy. One such herbal compound is ursolic acid (UA), a triterpene known for its anti-inflammatory, antioxidant, and antitumor properties. This study aimed to evaluate the effects of UA on bladder and ovarian cancer cells harboring TP53 mutations through various assays, including cytotoxicity, clonogenic survival, cell migration, morphological changes, apoptosis, cell cycle analysis, JHDM1D expression and selectivity using MRC-5 cells, along with in silico evaluation. The treatment demonstrated selectivity for tumoral cells and significant antiproliferative effects in both cell types, leading to decreased cell viability, reduced colony-forming ability, inhibited cell migration, morphological changes characteristic of cell death, and increased expression of JHDM1D. In conclusion, UA exhibited antiproliferative activity against bladder and ovarian cancer cell lines with different TP53 mutation sites, suggesting its potential as a promising therapeutic alternative. Moreover, our study demonstrated for the first time the presence of UA in the species F. formosa.	bladder
Development and external validation of a FISH-clinical nomogram for predicting overall survival in bladder cancer patients after radical cystectomy.	BACKGROUND: Bladder cancer has notable heterogeneity. The urine-based fluorescence in situ hybridization (FISH) test can detect bladder cancer noninvasively. In this study, we aimed to construct a nomogram based on FISH results and clinical features (referred to as the FISH-clinical model) to predict the overall survival (OS) of bladder cancer patients following radical cystectomy (RC). METHODS: A total of 261 eligible patients were enrolled for this study. The SYSMH cohort was divided into training (n = 138) and internal validation (n = 70) sets; the SYSUTH cohort was used for external validation (n = 53). Multivariate Cox proportional hazards regression was applied for FISH-clinical model construction, and model performance was evaluated according to analyses of calibration, discrimination ability, and clinical usefulness. RESULTS: FISH-identified chromosome 7 and 17 aneuploidies correlated significantly with increased pT stage; the former was associated with lymph node metastasis. Six variables, age, tumor size, pT stage, lymphovascular invasion, chromosome 7 aneuploidy, and p16 locus loss, were found to be independent predictors of OS and were incorporated into our FISH-clinical model. The model demonstrated good calibration and discrimination, with C-indexes (95% CIs) of 0.772 (0.693-0.851), 0.712 (0.605-0.819) and 0.705 (0.587-0.822), in the training, internal validation and external validation sets respectively. Decision curve analysis demonstrated the model's clinical utility. Furthermore, all enrolled patients were successfully categorized into high-, medium- or low-risk groups, and stratified analyses were performed. CONCLUSIONS: Preoperative FISH has predictive value for OS, and we developed a FISH-clinical model for OS prediction in bladder cancer patients who have not received neoadjuvant chemotherapy or immunotherapy. This model showed favorable predictive efficacy with internal and external validation.	bladder
Lapachol interferes with the cell cycle and inhibits proliferation and migration of bladder tumor cells with effects on ncRNA expression.	Bladder cancer is one of the most prevalent cancers worldwide. Lapachol is a natural compound with antiproliferative effects, but its activity in bladder cancer cells has not yet been evaluated. Cytotoxic activity was assessed using the MTT assay, while long-term effects were evaluated through the clonogenic assay. Cell migration was assessed by the scratch assay, and cell cycle progression was analyzed via flow cytometry. The expression of the JHDM1D gene and the long non-coding RNAs (lncRNAs) JHDM1D-AS1, SBF2-AS1, and RP11-36E7.4 was investigated. Treatment resulted in a dose- and time-dependent inhibition of cell viability, accompanied by a significant reduction in clonogenic survival in all cell lines. Lapachol impaired cell migration, with RT4 cells showing the greatest sensitivity. Cell cycle analysis revealed a significant increase in the sub-G1 cell population, indicative of apoptosis, and a concomitant decrease in the G0/G1 phase. Molecular analysis revealed modulation of lncRNA expression in a cell-line-specific manner. In RT4 cells, there was a downregulation of SBF2-AS1 expression. In J82 cells, a decrease in JHDM1D-AS1 and an increase in RP11-36E7.4 expression were observed. These findings suggest that lapachol exerts significant antiproliferative effects on bladder cancer cells through mechanisms involving cell cycle arrest, apoptosis induction, and modulation of lncRNA expression, supporting its potential for bladder cancer treatment.	bladder
TGF-β signaling and tumor microenvironment dynamics in bladder cancer progression post-BCG therapy: a longitudinal single-nucleus RNA-seq study.	BACKGROUND: Although non-muscle-invasive bladder cancer (NMIBC) frequently recurs and progresses despite BCG therapy, cellular mechanisms behind this remain unclear. Understanding the dynamics within the tumor microenvironment (TME) and identifying pathways associated with BCG resistance are crucial for improving NMIBC treatment. METHODS: To elucidate transcriptional dynamics and key cellular interactions in the TME, we performed longitudinal single-nucleus RNA sequencing of 9 NMIBC cases with three pairs of treatment-naïve and disease progression samples. The resulting 58,037 nuclei were subject to cell type and subtyping annotations along with cell-cell interaction analyses. RESULTS: Our analysis revealed marked interpatient heterogeneity in malignant cells, accompanied by copy number alterations associated with disease progression. TGF-β signaling emerged as a key pathway, showing gradual enrichment from pre-treatment to post-progression samples. Within the tumor microenvironment, we identified distinct subtypes including LAMP3 + dendritic cells and iCAF fibroblasts that followed unique pseudotime trajectories linked to progression. Cell-cell interaction analysis further highlighted critical ligand-receptor pairs such as DSC2-DSG2 and ENG-BMPR2, which were associated with poor clinical outcomes. These interactions may represent hypothesis-generating candidates that warrant further validation. CONCLUSIONS: This study highlights key cellular and molecular mechanisms underlying bladder cancer progression Post-BCG treatment. Through single-nucleus RNA sequencing, we identified critical TME subtypes, TGF-β signaling involvement, and crucial ligand-receptor interactions such as DSC2-DSG2 and ENG-BMPR2, which may serve as preliminary biomarkers requiring confirmation in larger independent cohorts. These findings offer valuable insights into enhancement of treatment strategies and patient outcomes.	bladder
TUBB3 Is Associated With a Poor Prognosis and Basal Subtypes in Upper and Lower Tract Urothelial Carcinoma.	OBJECTIVES: β3-tubulin, which is encoded by tubulin-β3 (TUBB3), is a microtubule protein. Although previous studies have indicated that TUBB3 overexpression is associated with a poor prognosis and chemoresistance in bladder cancer (BLCA), no studies have conducted comprehensive in silico analyses of urothelial carcinoma (UC) via public databases. We aimed to analyze the role of TUBB3 in UC via immunohistochemistry (IHC) and public database analysis. METHODS: We performed IHC and in silico analyses to investigate the clinicopathological significance of TUBB3 in UC, evaluated its role in determining the molecular subtype, and examined its impact on the effectiveness of chemotherapy, BCG treatment, and immunotherapy in patients with UC using public databases. RESULTS: IHC revealed that 18 of 71 (25.4%) BLCA cases were positive for β3-tubulin. The β3-tubulin-positive group had a greater disease stage and poorer cancer-specific survival (CSS). In silico analysis revealed that there was significant upregulation of TUBB3 expression in BLCA, particularly in muscle-invasive bladder cancer (MIBC), relative to normal urothelium. High TUBB3 expression was associated with the basal molecular subtype and a poor prognosis. There was no association between the expression of TUBB3 and the efficacy of BCG therapy, cisplatin-based chemotherapy, or immunotherapy. The high expression of TUBB3 was also associated with aggressive features, a poor prognosis, and the basal subtype of upper-tract urothelial carcinoma (UTUC). CONCLUSIONS: TUBB3 may play an essential role in the development and progression of UC. TUBB3 was associated with the basal subtype. TUBB3 could be a potential therapeutic target and biomarker in UC.	bladder